NPIMap

Organization Active NPI

Brookhaven Rest Home

  • Custodial Care Facility
  • W. Brookfield, MA
National Provider Identifier
1457476095
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
1247 Issued in MA
Legal business name
BROOKHAVEN REST HOME
Practice address
W. Main Street
W. Brookfield, MA 01585
Phone
(508) 867-3325
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nancy Besardi
Title
Administrator
Phone
(508) 867-3325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X 1247 MA Primary

Addresses

Primary practice location

W. Main Street
W. Brookfield, MA 01585

Mailing address

PO Box 556
W Brookfield, MA 01585-0556
Phone (508) 867-3325

Other identifiers 1

IdentifierTypeStateIssuer
5508126OtherMAPROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Brookhaven Rest Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457476095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "W BROOKFIELD",
            "state": "MA",
            "postal_code": "015850556",
            "telephone_number": "508-867-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W. MAIN STREET",
            "city": "W. BROOKFIELD",
            "state": "MA",
            "postal_code": "01585",
            "telephone_number": "508-867-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BESARDI",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "508-867-3325"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MA",
            "license": "1247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "5508126",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in W. Brookfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.